Prevention of Children’s Exposure to Second-Hand Smoke: A Biochemical Feedback Intervention Focused on Stage of Behavioral Change

Objective:To determine the impact of an intervention in which a child’s urinary cotinine value is told to smoking family members on stage of behavioral change for smoking cessation, and to investigate factors that contribute to the progression of stage of behavioral change among smoking family members. Methods:Participants were smoking family members of children enrolled at five kindergartens in two cities in Japan between December 2009 and January 2011. The stage of behavioral change before and after the intervention and related variables were measured by self-administered questionnaires. Statistical analyses were performed using the Wilcoxon signed-rank test and multivariate logistic regression analysis. Results:Valid responses were obtained from 110 participants in 101 households. Before the intervention,39 participants(35.5%)were in the first half of the pre-contemplation stage,53 participants (48.2%) were in the latter half of the pre-contemplation stage, 18 participants (16.4%) were in the contemplation stage,and no participants(0.0%)were in the preparation stage. A significant difference in stage of behavioral change was found before and after the intervention (z=-3.350,p=0.001). The stage of change progressed after the intervention. The lower the stage of behavioral change for smoking cessation before the intervention (odds ratio[OR]11.90,95% confidence interval[CI]2.24-63.30,p< 0.01)or the higher a parent’s anxiety regarding the children’s health (OR 4.23,95%CI 1.34-13.30,p< 0.05),the more the intervention led to a progression in the stage of behavioral change. Conclusion:A biochemical feedback intervention for smoking family members who are in the first half of the precontemplation stage could lead to progress in the stage of behavioral change among smokers,and this progress might lead to an increase in the number of quitters.(Kitakanto Med J 2014;64:125~134)